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All Journal Majalah Kedokteran Nusantara The Journal Of Medical School Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD)
Santi Syafril
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Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Hashitoxicosis: A Case Report Dhini Sylvana; Dharma Lindarto; Santi Syafril; Melati Silvanni Nasution; Dian Anindita Lubis; Stephen Udjung
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes Vol. 2 No. 1 (2025): InaJEMD Vol. 2, No. 1
Publisher : PP PERKENI

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Abstract

Hashimoto Thyroiditis with Grave’s disease/Hashitixicosis is found in some cases, snd this case repirt describes a case of a woman with Hashitoxicosis. A 27 year old woman came to polyclinic on 18th March 2024 with complain of a lump felt, fatique, constipation and weight loss two month before she had weight gain later without any treatment. She was compomentis, BP 149/90 mmHg, HR 87x/i, Wayne index 0, Billewicz score -22. TSH 93.40 mclU/mL and FT4 0.39 ng/dL, anti-TPO >1000 Iau/mL, TRAb 2.46 IU/L. Thyroid ultrasound showed toxic diffuse struma, thyroid scintigraphy revealed enlarge lobes with high and even distribution and capture of radioactivity with conclusion Toxic Diffuse Struma, and cytologic examination showed colloid goiter. Patient was diagnosed as Hashitoxicosis and has been treated with levothyroxine 100 mg once daily. This woman was diagnosed as Hashitoxicosis based on clinical features of hypothyroidism at admission to polyclinic following clinical features of hyperthyroidism initially without any treatment, with laboratory results showed hypothyroidism with the increased of antibody for Hashimoto Thyroiditis and Grave’s disease. Treatment with levothyroxine 100 mg once daily showed the decrease of TSH and normal FT4 level. We report a case of Hashitoxicosis based on clinical features of hypothyroid following hyperthyroidism initially, laboratory, thyroid ultrasound thyroid scintigraphy, and cytologic examination result. Treatment with levothyroxine showed improvement.
The Relationship Between Asymmetric Dimethylarginine and Ankle-Brachial Index With the Severity of Diabetic Foot Ulcers Mardia, Indra Kusuma; Santi Syafril; Brama Ihsan Sazli
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 7 No. 4 (2025): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v7i4.19466

Abstract

ABSTRACT   Introduction: Approximately 50% of inpatient cases for diabetic complications are diabetic foot ulcers (DFU). Peripheral artery defect is one of the mechanisms that is characterized by increased asymmetric dimethylarginine (ADMA). Severe diabetic foot ulcers are found in populations with low ankle-brachial index (ABI) values. This study aims to find the relationship between ADMA and ABI in predicting risk for DFU. Methods: An Observational study with a cross-sectional method was conducted at Adam Malik Hospital, Medan collaboration with the Clinical Laboratory from the Faculty of Medicine, Universitas Sumatera Utara. Forty-two patients with DFU from September 2023 to April 2024 were registered with the following information: anthropometric, gender, history of drug use, comorbidities, ABI, ADMA, complete blood count, lipid profile, and fasting blood glucose. Results: In grade II DFU, the average ADMA value was 87.6 ng/dl, grade III 231.3 ng/dl, grade IV 444.9 ng/dl, and grade V 652.3 ng/dl. ABI value using Sokoye classification shows grade II DFU has an average ABI value of 1.08 (Normal), grade III 0.74 (Mild), Grade IV 0.61 (Moderate), and grade V 0.5 (Moderate). There is a significant relationship between the severity of DFU (Wagner scale) and ADMA levels (P = 0.001) and  ABI values ​​(P = 0.001). There is a relationship between ADMA and ABI values with DFU (P = 0.001). Conclusion: There is a significant relationship between the severity of DFU (Wagner scale) and ADMA levels (P = 0.001) and  ABI values ​​(P = 0.001). There is a relationship between ADMA and ABI values with DFU (P = 0.001). Keywords: Diabetic foot ulcer, Asymmetric dimethylarginine, Ankle-brachial index       ABSTRAK   Pendahuluan: Sekitar 50% kasus rawat inap untuk komplikasi diabetes adalah diabetic foot ulcers (DFU). Cacat arteri perifer adalah salah satu mekanisme yang ditandai dengan peningkatan asymmetric dimethylarginine (ADMA). Ulkus kaki diabetes parah ditemukan pada populasi dengan ankle-brachial index (ABI) values. Penelitian ini bertujuan untuk mengetahui hubungan antara ADMA dan ABI dalam memprediksi risiko untuk DFU. Metode: Studi Observasional dengan metode cross-sectional dilakukan di Rumah Sakit Adam Malik Medan bekerja sama dengan Laboratorium Klinik dari Fakultas Kedokteran, Universitas Sumatera Utara. Empat puluh dua pasien DFU dari September 2023 hingga April 2024 terdaftar dengan informasi dari antropometri, jenis kelamin, riwayat penggunaan narkoba, komorbiditas, ABI, ADMA, hitung darah lengkap, profil lipid, dan glukosa darah puasa sebagai berikut.. Hasil: Nilai ADMA rata-rata DFU kelas II: 87,6 ng/dl, grade III: 231,3 ng/dl, grade IV: 444,9 ng/dl, dan grade V: 652,3 ng/dl. Nilai ABI menggunakan klasifikasi Sokoye menunjukkan DFU grade II memiliki nilai ABI rata-rata 1,08 (Normal), grade III 0,74 (Mild), Grade IV 0,61 (Moderate), dan grade V 0,5 (Moderate). Terdapat hubungan antara tingkat keparahan DFU (skala Wagner) dengan kadar ADMA (P = 0,001) dan nilai ABI (P = 0,001). Ada hubungan antara nilai ADMA dan ABI dengan DFU (P = 0,001). Kesimpulan: Ada hubungan antara tingkat keparahan DFU (skala Wagner) dengan kadar ADMA (P = 0,001) dan nilai ABI (P = 0,001). Ada hubungan antara nilai ADMA dan ABI dengan DFU (P = 0,001). Kata kunci: Ulkus kaki diabetik, Asimetris Dimetilarginin, ABI    
Co-Authors Brama Ihsan Sazli dharma Lindarto, dharma Dhini Sylvana Dian Anindita Lubis Gema Nazri Yanni Ginting, Priska Krinanta Mardia, Indra Kusuma Melati Silvanni Nasution Nasution, Melati Silvanni Neny Pristiwati Harahap Noni Novisari Soeroso Ozar Sanuddin Pangaribuan, Jessica Patricia Prianwari, Catur Putri, Indah Prasetya R Lia Kusumawati Sitepu, Annisa Nidya Stephen Udjung Sylvana, Dhini Tantri, Anita Ratnasari Yulia Ramdhani